Transmission permeability of tuberculosis involving immigrants, revealed by a multicentre analysis of clusters

In recent years, the number of cases of tuberculosis (TB) among immigrants in Spain has increased markedly, and led to this analysis of the recent transmission patterns of TB in the immigrant population in Madrid. The countries from which the highest number of immigrant cases have been reported were Ecuador (21%), Romania (16%), Morocco (12%), Peru (11%) and Bolivia (9%). Fifty-one per cent of the cases were from South America. In a multicentre study (2004–2006), IS 6110 restriction fragment length polymorphism and spoligotyping were used to genotype the Mycobacterium tuberculosis isolates from 632 immigrant cases from 47 countries. A total of 183 cases (29%) were grouped into 59 clusters, which are markers of potential transmission events. Most of the clusters (81%) included patients living in different healthcare districts, and 54% of the clusters were multinational. When a sample of 478 autochthonous cases was included, 53% of the clusters involving immigrants also included autochthonous cases. This study revealed marked transmission permeability among nationalities and between the immigrant and the autochthonous populations.     

2006年陕西公众结核病防治知识核心信息知晓情况调查

目的了解陕西公众结核病知识核心信息知晓情况,为更有效地开展结核病防治健康教育提供依据。方法采用分层系统随机抽样方法,在全省抽取7个县区共8119名城乡居民。使用统一设计的调查问卷对调查对象进行入户面对面询问式调查。结果调查对象的核心信息总知晓率为49.5%,其中男性总知晓率为52.0%,女性为47.0%,城区居民总知晓率为62.7%,农村居民为47.5%。自述周围有人患有肺结核病的人群,其核心信息总知晓率为60.9%。12~19岁组、小学及以下文化程度者、学生和农民知晓率较低。调查对象对肺结核病的传染性、传播途径的知晓率较高,而一半或超过一半的调查对象不知道当地有检查和治疗结核病的专门机构、结核病人应到专门机构检查治疗、国家有免费检查治疗政策、不应该歧视结核病人,尤其是对＂咳嗽咳痰3周以上或有咯血、血痰症状者应怀疑得了肺结核病＂这条核心信息的知晓率只有20.2%。结论被调查人员结核病核心信息知晓率较低,不同特征居民间知晓率有差别,应根据当地居民结核防治知识的知晓情况制定相关政策。     

Intracranial non-Hodgkin lymphoma occurring after treatment of Hodgkin disease

Patients with successfully treated Hodgkin disease are at increased risk for the development of second malignancies. We present two cases of intracranial non-Hodgkin lymphoma that appeared following successful treatment of Hodgkin disease. The appearance of the lymphomas on computed tomographic images is shown, and possible predisposing factors, differential diagnosis, and clinical implications are discussed.     

Preliminary investigations on androgen receptor gene mutations in infertile men

A total of 50 men were selected from all patients attending an infertility clinic on the basis of oligozoospermia or azoospermia with concentrations of luteinizing hormone >6 IU/l and testosterone >30 nmol/l. Six of these men responded to written invitation and DNA was extracted from blood leukocytes. Individual exons of the androgen receptor gene were amplified by polymerase chain reaction and screened for the presence of mutations by denaturing gradient gel electrophoresis. The glutamine rich portion of exon 1 was sequenced directly. All of the coding sequence of the gene was examined except the glycine rich portion of exon 1 in all patients. No mutations or deletions were identified. Androgen receptor gene mutations do not appear to be present in infertile men with biochemical disturbances compatible with androgen resistance. It is therefore unlikely that such mutations are a major factor in the pathogenesis of oligozoospermia/azoospermia and infertility.      

New live mycobacterial vaccines: the Geneva consensus on essential steps towards clinical development

As the disease caused by Mycobacterium tuberculosis continues to be a burden, which the world continues to suffer, there is a concerted effort to find new vaccines to combat this problem. Of the various vaccines strategies, one viable option is the development of live mycobacterial vaccines. A meeting with researchers, regulatory bodies, vaccines developers and manufactures was held to consider the challenges and progress, which has been achieved with live mycobacterial vaccines (either modified BCG or attenuated M. tuberculosis). Discussion led to the production of a consensus document of the proposed entry criteria for Phase I clinical trials of candidate live mycobacterial vaccines. The vaccine must be characterised thoroughly to prove identity and consistency, as clinical trial lots are prepared. In pre-clinical studies, greater protective efficacy as well as improved safety potential relative to BCG should be considered when assessing potential vaccine candidates. A standard way to measure the protective efficacy to facilitate comparison between vaccine candidates was suggested. Additional safety criteria and verification of attenuation must be considered for attenuated M. tuberculosis. Two non-reverting independent mutations are recommended for such vaccines. When entering Phase I trials, enrollment should be based upon an acceptable characterisation of the study population regarding mycobacterium status and exclude HIV(+) individuals. BCG could be used as a comparator for blinding during the trials and to properly assess vaccine-specific adverse reactions, while assays are being developed to assess immunogenicity of vaccines. The proposed criteria suggested in this consensus document may facilitate the movement of the most promising vaccine candidates to the clinic and towards control of tuberculosis.     

Positional cloning of a gene involved in hereditary multiple exostoses

Hereditary multiple exostosis (EXT) is an autosomal dominant condition mainly characterized by the presence of multiple exostoses on the long bones. These exostoses are benign cartilaginous tumors (enchondromata). Three different EXT loci on chromosomes 8q (EXT1), 11p (EXT2) and 19p (EXT3) have been reported, and recently the EXT1 gene was identified by positional cloning. To isolate the EXT2 gene, we constructed a contig of yeast artificial chromosomes (YAC) and P1 clones covering the complete EXT2 candidate region on chromosome 11p11-p12. One of the transcribed sequences isolated from this region corresponds to a novel gene with homology to the EXT1 gene, and harbours inactivating mutations in different patients with hereditary multiple exostoses. This indicates that this gene is the EXT2 gene. EXT2 has an open reading frame encoding 718 amino acids with an overall homology of 30.9% with EXT1, suggesting that a family of related genes might be responsible for the development of EXT.      

结核病控制策略对患者涂阳率的影响

目的：探讨不同结核病控制策略与复治涂阳患形成的关系。方法：对宁夏实施世界银行贷款结构病控制项目前后两个不同时期结核病统计报表进行统计学X^2检验及直线相关分析。结果：宁夏实施项目以前的结核病控制策略导致新发涂阳肺结核患治愈率仅为34．33％，同期复治涂阳结核患比例高达68．79％，实施直接面视下短程化学疗法策略，使新发涂阳患治愈率提高到95％以上，同期复治涂阳肺结核患比例最低下降到18．27％，经相关处理，新发涂阳肺结核患的治愈率与复治涂阳患的比例之间呈明显的负相关。结论：现代结核商控制的直接面视下短程化学疗法策略能大幅度地养活复治涂阳患和耐多药结核患的产生。